在可植入心脏转换器-除器中检测室内节律失常的左束枝节奏带头:试点研究 (LBBP-ICD研究)
Shunmuga Sundaram Ponnusamy1, Vadivelu Ramalingam1, Selvaganesh Mariappan1
1Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India.
Heart rhythm
|December 24, 2023
概括
左束枝节奏 (LBBP) 对于检测需要除器的患者的心室失律是安全的. 这种方法有效地感知和治疗心律失常,改善心脏功能.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 左捆枝节奏 (LBBP) 为心脏再同步治疗 (CRT) 提供了双心室节奏的替代方案.
- 由于LBBP的稳定R波传感,可以在使用可植入心脏转换器-除器 (ICD) 和CRT的患者中检测心室节律失常.
研究的目的:
- 为了评估LBBP的长期安全性和有效性.
- 评估适当检测心室节律失常和抗心动节拍 (ATP) 输送.
- 分析需要使用CRT进行除器治疗的患者的LBBP性能.
主要方法:
- 招募了符合CRT条件的患者,他们接受了LBBP优化的ICD和/或带除器的CRT.
- 连接的LBBP导入右心室P/S端口,封闭ICD导入的IS-1连接器.
- 分析记录的心律失常发作,并根据导电系统疾病纠正提供治疗.
主要成果:
- 在LBBP中,左心室喷射率从29.9%提高到43.9%.
- 在22.9个月的随访期间,在254个心室节律失常事件中,有89%被适当检测出来.
- 抗心动节拍 (ATP) 疗效在心室性心动节拍 (VT) 中为75%;5.5%的发作因T波过度传感而获得不适当的ATP.
结论:
- 对于检测心律失常的LBBP探测是安全的,大约有90%的适当检测率.
- 需要进一步研究专门的LBBP除器导线和改进的算法.
- 将除与传导系统节奏相结合,对未来的CRT-ICD系统有很大的希望.
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